Emergence of melioidosis in the Indian Ocean region: Two new cases and a literature review

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Melioidosis is a disease caused by bacteria called B. pseudomallei.Infections can develop after contact with standing water.This disease can reach all the organs and especially the lungs.It is associated with a high mortality rate (up to 50%).Melioidosis is endemic in northern Australia and in Southeast Asia.Nevertheless, B. pseudomallei may be endemic in the Indian Ocean region and in Madagascar in particular, so clinicians and microbiologists should consider acute melioidosis as a differential diagnosis in the Indian Ocean region, in particular from Madagascar. OverviewMelioidosis is a frequent disease caused by Burkholderia pseudomallei and found mostly in northern Australia and Southeast Asia.In the last decade, increasingly more cases of melioidosis have been reported in the Indian Ocean region, particularly in Madagascar.Here, we report two new cases of melioidosis complicated by multiple organ failure that were observed in Re ´union Island.The two affected patients came from abroad: one patient -whose diagnosis was delayed by one year-came from Madagascar, and the other came from Southeast Asia.Our two cases and our literature review suggest the importance of considering the diagnosis of melioidosis in patients returning from the Indian Ocean region, in particular from Madagascar.Further studies are needed in order to investigate the real incidence of melioidosis in the Indian Ocean region (especially in Madagascar) because this incidence may be higher than assumed.